Understood for years in Europe, Americans are now catching on to the important connection between blood sugar and chronic disease. Joysa Winter explores the sweeter side of the slow-carb trend
For finished-food manufacturers, it's a good time to be in the low-glycaemic market. With the deadly triad of obesity, diabetes and heart disease continuing to grow in the United States, and now being exported abroad, scientists are dedicating more and more research dollars to better understand blood sugar's role in human health.
Sales of low-glycaemic foods and beverages are expected to grow to $1.8 billion in 2011, according to Packaged Facts' 2006 Glycemic Index Foods and Beverages in the US, representing an annual growth rate of 45.7 per cent. "The current adult- and childhood-obesity epidemic, coupled with the increase in the prevalence of diabetes and other diet-related ailments such as heart disease, are key driving forces in the labelling of glycaemic and glucose on product labels," the report states. "There's also growing consumer awareness of the impact carbohydrate choice has on general health and wellness."
The awareness has been slow. Foods labelled as low glycaemic have been on store shelves for more than two decades, but they didn't begin appearing in mainstream US supermarkets until 2003. Their initial impact was minimal, and it wasn't until after the failure of the low-carb diet fad that consumers began to understand that not all carbs are alike.
Presently, Packaged Facts estimates that snack, nutritional and meal-replacement bars control 60 per cent of the low-glycaemic food and beverage market. Beverages come in second with a 30 per cent share. The other 10 per cent share is fragmented, with about five per cent coming from cookies. Candies, frozen desserts and table sweeteners, making up a 'sweets' category, claim the smallest four per cent share. Though in a random sample of 250 consumers, German-based Beneo-Palatinit, makers of alternative-sweetener candies, found that 30 per cent already eat sugar-free confectionery on a regular basis, and another 80 per cent reported they would eat candy sans sugar, if sugar candies were no longer available.
The slow-carb movement is strongest in Europe, where Mintel reports that just over 34 per cent of UK consumers are now actively avoiding sugar, while in France and Germany, the figures are 40 per cent and 37 per cent, respectively. Sweden has gone so far as to officially approve a low-GI health claim. There, products that qualify can state: "(X) gives a low and slow blood-sugar response and has a scientifically tested low glycaemic index," per World Health Organization/Food and Agriculture Organization criteria.
Don't use the G word
Despite the growing popularity for products that minimize blood sugar, there is still widespread confusion among consumers, some of it stemming from the good-carb, bad-carb debate during the Atkins phenomenon. University of Virginia professor Glenn Gaesser, writing in the Journal of the American Dietetic Association (JADA) in October, 2007, concluded that dividing carbs into 'good' and 'bad' is misleading, and that such distinctions cannot prevent obesity.
Because of relatively low consumer understanding of phrases like 'glycaemic index' or 'glycaemic response,' National Starch advises its clients to not use such phrases on their labelling. "We do, however, recommend, that foods containing a sufficient quantity of Hi-maize resistant starch carry a structure/function claim that says the food 'helps maintain healthy blood-sugar levels as part of a high-fibre diet," says Rhonda Witwer, senior business development manager for National Starch Hi-maize resistant starch, Hi-maize whole-grain corn flour and Nutriose solube fibre.
As consumers see more finished products, expect to see product labelling that skirts around the G-word but appeals to consumer interest in energy, weight loss and digestion. It is common in Australia and South Africa to situate low-GI products as a means to sustain energy levels rather than weight loss, says a 2007 Mintel report, Satiety and Active Weight Management Trans-Category Trend.
Pharmachem Labs, Phase 2 Carb Controller has positioned its products, made from white kidney beans, with two permitted structure/function claims: "May aid in weight control when used in conjunction with a sensible diet and exercise," and "May reduce the enzymatic digestion of dietary starches."
"This is extremely important to our manufacturers," says Mitch Skop, director of new-product development. "Since Phase 2 delays the digestion and absorption of starchy foods, many of our customers seem most interested in the term 'slows digestion,' which can aid in both weight control and blood-glucose management."
The glycaemic debate
Still, even with the rising popularity, questions remain whether the interest in glycaemic and slow carbs is based on science or wishful thinking. Will glycaemic talk go the way of the low-carb diet fad — another bubble in our insatiable appetites for quick fixes? — or will it prove to be long-lasting? Science is mounting on the plus side of the debate.
In October, 2007, an American Journal of Clinical Nutrition study found that a breakfast high in insoluble fibre could aid weight loss by reducing appetite, lowering food intake and reducing the glycaemic response to a meal consumed 75 minutes later. The study sheds light on why consumption of insoluble fibre has previously been associated with a reduced risk of obesity and diabetes.1 The same journal also reported in July, 2007, that people at risk of declining sight from age-related macular degeneration may benefit from a low-GI diet.2
The real buzz in the industry, however, is coming from a new meta-analysis study — just published in March — which surveyed 37 published studies on the association between GI, glycaemic load (GL), and chronic-disease risk. The authors' conclusion is decisive: "Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole-grain and high-fibre intakes. The findings support the hypothesis that higher postprandial glycaemia is a universal mechanism for disease progression."3
For Tate & Lyle, as well as National Starch Food Innovation, the possibilities are endless as soluble fibre can be used in dairy, dressings, fillings and cereal coatings, and resistant starch has applications in cereals, snacks, crackers, breads and pastas. Foods once forbidden because of their low-nutrient profiles now show promise as metabolic boosters.
"The research suggests that the fermentation of Hi-maize resistant starch is responsible for its metabolism benefits," explains Witwer, "and its small particle size, white colour, bland flavour and low water-holding capacity make it easy to use as a one-for-one replacement for flour." The other added benefit is resistant starches are fermented in the large intestine but do not cause digestive side effects common to other fermentable fibres and nondigestible carbohydrates, such as sugar alcohols, Witwer says.
As with all things diet-related, there are detractors. Gaesser's research in JADA concludes that diets high in carbohydrates are almost universally associated with slimmer bodies, and consumption of high-glycaemic foods is not associated with higher body weights. On the contrary, he says, several large studies in the US reveal that high-glycaemic diets are linked to better weight control.
As far as Sherry Torkos, RPh, is concerned, the preponderance of scientific evidence still comes down on the side of low GI. "The majority of the studies on the effects of GI on body weight have yielded positive results," says Torkos, author of The GI Made Simple (Wiley, 2007) and spokesperson for Pharmachem Labs. "The benefits extend beyond weight loss. Following a low-GI diet has been shown in several studies to reduce risk factors for chronic disease such as diabetes and heart disease."
1. American Journal of Clinical Nutrition, Vol. 86, No. 4, 972-979, October 2007. "Insoluble cereal fibre reduces appetite and short-term food intake and glycemic response to food consumed 75 min later by healthy men."
2. American Journal of Clinical Nutrition, Vol. 86, No. 1, 180-188, July 2007. "Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study."
3. American Journal of Clinical Nutrition, Vol. 87, No. 3, 627-637, March 2008
4,5. Journal of the American Dietetic Association, Vol. 107, Issue 10, 1768-1780, October 2007
6. Diabetes Care 2007 30: 2804-2810, November 2007.